US4501029A - Tendon repair - Google Patents

Tendon repair Download PDF

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Publication number
US4501029A
US4501029A US06/484,606 US48460683A US4501029A US 4501029 A US4501029 A US 4501029A US 48460683 A US48460683 A US 48460683A US 4501029 A US4501029 A US 4501029A
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tendon
sheath
passages
main tube
replacement
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Expired - Fee Related
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US06/484,606
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Derek J. W. McMinn
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/08—Muscles; Tendons; Ligaments
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges

Definitions

  • This invention relates to a device for assisting in the repair of severed tendons.
  • a device for assisting in repair of a severed tendon comprises a main tube for insertion between a replacement tendon and its sheath, and a plurality of transversely extending passages which communicate with the bore of said main tube at intervals over substantially the whole length thereof, the lengths of said passages being at least equal to the minimum required lengths of blood vessels between the tendon and its sheath which will permit free movement of the tendon within the sheath.
  • FIG. 1 is an external view of part of a device according to the invention
  • FIG. 2 is a view on arrow 2 in FIG. 1;
  • FIG. 3 is a section on line 3--3 in FIG. 2;
  • FIG. 4 is a longitudinal section of an alternative form of device, in position between a tendon and its sheath, and
  • FIG. 5 is a section, corresponding to FIG. 3, of a further alternative form of the device.
  • a tube 10 is intended to assist in repair of a tendon of the hand.
  • the tube 10 has an overall length of 20 cm, an axial bore 11 having a diameter of 4 mm and an outer circumference 12 having a diameter of 7 mm.
  • Communicating with the bore 11 and extending transversely thereof are a plurality of passages 13 which are housed in projections 14 from the main body of the tube 10 and moulded integrally therewith.
  • Each of the passages 13 and its surrounding projection 14 is at an angle of 15° to the bore 11, and all of the projections 14 are directed towards one end of the tube 10.
  • the passages 13 have bores of 2 mm diameter and the projections 14 have outside diameters of 4 mm.
  • each of the passages 13 is equal to at least half the anticipated distance of movement of the tendon to be repaired, and is typically at least 20 mm.
  • the passages 13 are evenly spaced along the length of the tube 10 at intervals of 10 mm.
  • the passages 13 and their surrounding projections 14 are angularly spaced about the axis of the bore 11, but it will readily be understood that they could, if desired, be located on alternate opposite sides of the tube 10, or in any other arrangement which might be convenient for the particular use to which they are to be put.
  • the tube 10 is formed of a synthetic material which is absorbable within the human body.
  • a synthetic material is polyglycolic acid which, in contact with the body breaks down to its amino acid components, these being subsequently metabolised.
  • the alternative embodiment shown in FIG. 4 has the passages 13 at an angle of 10° with the axis of the bore 11.
  • the projections 14 extend for a less distance radially of the bore 11 and are, in fact, integral with the remainder of the tube 10 over the whole of their length.
  • the tube 10 is inserted in a tendon sheath 15 (FIG. 4) and the replacement tendon 16 is threaded through the bore 11 and its opposite end secured to adjacent ends of the undamaged part of the original tendon. Blood supply to the replacement tendon from its sheath is established through the passages 13.
  • the fibrous tissue surrounding the new blood vessels has a length equivalent to that of the passages 13, and subsequent breakdown of the tube 10 permits the replacement tendon to move freely within its sheath.
  • the tube is of an elastomeric flexible material which is not absorbable in the body, for example a silicone rubber of the type marketed by Dow Corning under the name SILASTIC.
  • the passages 13 are provided within thin-walled silicone rubber tubes 20 which extend transversely of the bore 11 and are secured to the wall thereof.
  • the passages have bores of 2 mm and lengths equal to at least half the anticipated movement of the replacement tendon in its sheath, these length typically being at least 20 mm.
  • this last embodiment is located, as before, between a replacement tendon and its sheath, and blood supply to the replacement tendon is established through the passages 13.
  • the device is, however, allowed to remain in place within the tendon sheath, the thin-walled tubes 20 flexing with movement of the tendon.
  • Each of the described embodiments permits re-establishment of blood supply to a replacement tendon, along paths whose lengths correspond to those of viniculae associated with an undamaged tendon.

Abstract

A device for assisting in repair of a severed tendon comprises a main tube for insertion between a replacement tendon and its sheath, and a plurality of passages extending transversely of the bore of the main tube and communicating therewith, through which passages a blood supply from the sheath to the replacement tendon is established. The lengths of the passages are such that free movement between the tendon and its sheath is permitted after the blood supply is established.

Description

This invention relates to a device for assisting in the repair of severed tendons.
It is usual to effect repair of a severed tendon by threading a replacement tendon through the tendon sheath and securing the ends of the replacement tendon to undamaged parts of the original tendon. Blood supply to a tendon is by way of fine blood vessels, or viniculae which extend between the tendon and its sheath and are of sufficient length as to enable the required movement of the tendon within the sheath, this movement being as much as 35 mm in the tendons of the hand. However, the blood supply to a replacement tendon tends to be re-established by the shortest routes between the tendon and sheath, and the fibrous tissue surrounding the re-established blood vessels serves to prevent movement of the tendon, and hence of the member which it controls. It is therefore common practice to perform a second operation to sever those fibrous tissues to restore some mobility to the member.
The foregoing procedures frequently result in some permanent impairment of mobility. Such impairment is particularly disadvantageous when tendons have been severed in the hand or the wrist, which is a common form of industrial accident.
It is an object of the present invention to provide a device which, when used in the repair of severed tendons will permit re-establishment of blood supply to the tendons, without the foregoing disadvantages.
According to the invention, a device for assisting in repair of a severed tendon comprises a main tube for insertion between a replacement tendon and its sheath, and a plurality of transversely extending passages which communicate with the bore of said main tube at intervals over substantially the whole length thereof, the lengths of said passages being at least equal to the minimum required lengths of blood vessels between the tendon and its sheath which will permit free movement of the tendon within the sheath.
Embodiments of the invention will now be described by way of example only, and with reference to the accompanying drawings in which:
FIG. 1 is an external view of part of a device according to the invention;
FIG. 2 is a view on arrow 2 in FIG. 1;
FIG. 3 is a section on line 3--3 in FIG. 2;
FIG. 4 is a longitudinal section of an alternative form of device, in position between a tendon and its sheath, and
FIG. 5 is a section, corresponding to FIG. 3, of a further alternative form of the device.
As shown in FIGS. 1 to 3, a tube 10 is intended to assist in repair of a tendon of the hand. The tube 10 has an overall length of 20 cm, an axial bore 11 having a diameter of 4 mm and an outer circumference 12 having a diameter of 7 mm. Communicating with the bore 11 and extending transversely thereof are a plurality of passages 13 which are housed in projections 14 from the main body of the tube 10 and moulded integrally therewith. Each of the passages 13 and its surrounding projection 14 is at an angle of 15° to the bore 11, and all of the projections 14 are directed towards one end of the tube 10. The passages 13 have bores of 2 mm diameter and the projections 14 have outside diameters of 4 mm. The minimum length of each of the passages 13 is equal to at least half the anticipated distance of movement of the tendon to be repaired, and is typically at least 20 mm. The passages 13 are evenly spaced along the length of the tube 10 at intervals of 10 mm. Conveniently, the passages 13 and their surrounding projections 14 are angularly spaced about the axis of the bore 11, but it will readily be understood that they could, if desired, be located on alternate opposite sides of the tube 10, or in any other arrangement which might be convenient for the particular use to which they are to be put.
The tube 10 is formed of a synthetic material which is absorbable within the human body. Such a material is polyglycolic acid which, in contact with the body breaks down to its amino acid components, these being subsequently metabolised.
The alternative embodiment shown in FIG. 4 has the passages 13 at an angle of 10° with the axis of the bore 11. In this embodiment the projections 14 extend for a less distance radially of the bore 11 and are, in fact, integral with the remainder of the tube 10 over the whole of their length.
For use of either of the foregoing embodiments the tube 10 is inserted in a tendon sheath 15 (FIG. 4) and the replacement tendon 16 is threaded through the bore 11 and its opposite end secured to adjacent ends of the undamaged part of the original tendon. Blood supply to the replacement tendon from its sheath is established through the passages 13. However, the fibrous tissue surrounding the new blood vessels has a length equivalent to that of the passages 13, and subsequent breakdown of the tube 10 permits the replacement tendon to move freely within its sheath.
In the further embodiment shown in FIG. 5 the tube is of an elastomeric flexible material which is not absorbable in the body, for example a silicone rubber of the type marketed by Dow Corning under the name SILASTIC. In this embodiment the passages 13 are provided within thin-walled silicone rubber tubes 20 which extend transversely of the bore 11 and are secured to the wall thereof. As before, the passages have bores of 2 mm and lengths equal to at least half the anticipated movement of the replacement tendon in its sheath, these length typically being at least 20 mm.
In use, this last embodiment is located, as before, between a replacement tendon and its sheath, and blood supply to the replacement tendon is established through the passages 13. The device is, however, allowed to remain in place within the tendon sheath, the thin-walled tubes 20 flexing with movement of the tendon.
Each of the described embodiments permits re-establishment of blood supply to a replacement tendon, along paths whose lengths correspond to those of viniculae associated with an undamaged tendon.

Claims (7)

I claim:
1. A device for assisting in repair of a severed tendon, comprising a main tube for insertion between a replacement tendon and its sheath, and a plurality of transversely extending passages which communicate with the bore of said main tube at intervals over substantially the whole length thereof, the lengths of said passages being at least equal to the minimum required lengths of blood vessels between the tendon and its sheath which will permit free movement of the tendon within the sheath.
2. A device as claimed in claim 1 in which said tube is of a synthetic material which is absorbable in the body.
3. A device as claimed in claim 2 in which said transversely-extending passages are moulded integrally with the remainder of said device.
4. A device as claimed in claim 1 in which said transversely-extending passages are provided within thin-walled flexible tubes.
5. A device as claimed in claim 4 in which said main tube and said thin-walled tubes are of an elastomeric material.
6. A method of repairing a severed tendon, including the steps of inserting into the sheath of the tendon a device comprising a main tube of flexible material and a plurality of transversely extending passages which communicate with the bore of said main tube at intervals over substantially the whole length thereof, the lengths of said passages being at least equal to the minimum required lengths of blood vessels between the tendon and its sheath which will permit free movement of the tendon within its sheath, inserting said replacement tendon through the bore of said main tube, and securing the ends of said replacement tendon to undamaged parts of the original tendon.
7. A method as claimed in claim 6 in which said device remains within said tendon sheath.
US06/484,606 1982-04-22 1983-04-13 Tendon repair Expired - Fee Related US4501029A (en)

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GB8211608 1982-04-22
GB8211608 1982-04-22

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Cited By (16)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0249346A2 (en) * 1986-05-15 1987-12-16 Jonathan Paul Beacon A prosthetic ligamentary device
US4795465A (en) * 1987-05-14 1989-01-03 Hood Laboratories Tracheobronchial stent
US4979956A (en) * 1987-10-30 1990-12-25 Pfizer Hospital Products Group, Inc. Device and method for tendon and ligament repair
US5061283A (en) * 1987-10-30 1991-10-29 Pfizer Hospital Products Group, Inc. Method for tendon and ligament repair
US5800544A (en) * 1994-12-02 1998-09-01 Omeros Medical Systems, Inc. Tendon and ligament repair system
US6106556A (en) * 1994-12-02 2000-08-22 Omeros Medical Systems, Inc. Tendon and ligament repair system
US20020022861A1 (en) * 2000-05-19 2002-02-21 Daniel Jacobs Multi-point tissue tension distribution device, a combined orbital rim repair and suspension variation, and a method of tissue approximation using the device
US20020084078A1 (en) * 1999-02-26 2002-07-04 Shell Oil Co. Method of operating an apparatus for radially expanding a tubular member
US20020169477A1 (en) * 2000-02-07 2002-11-14 Omeros Medical Systems, Inc. Soft tissue repair system
US20030142676A1 (en) * 2002-01-25 2003-07-31 Raymond Zeisz Method and apparauts for admission control in packet switch
US20040010276A1 (en) * 2000-05-19 2004-01-15 Daniel Jacobs Multi-point tissue tension distribution device and method, a chin lift variation
US6740100B2 (en) 1999-12-23 2004-05-25 Omeros Corporation Tendon repair using adhesive
US20050119694A1 (en) * 2000-05-19 2005-06-02 Jacobs Daniel I. Remotely anchored tissue fixation device and method
US20050197699A1 (en) * 2004-02-10 2005-09-08 Jacobs Daniel I. Tissue repair apparatus and method
US20050209542A1 (en) * 2004-03-16 2005-09-22 Jacobs Daniel I Tissue approximation sling and method
US20080021554A1 (en) * 2004-12-13 2008-01-24 Stone Kevin T Composite Collagen Material And Method Of Forming Same

Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3463158A (en) * 1963-10-31 1969-08-26 American Cyanamid Co Polyglycolic acid prosthetic devices
US3577837A (en) * 1968-04-30 1971-05-11 Karl F Bader Jr Subdermal tendon implant
US3786817A (en) * 1972-06-01 1974-01-22 Palma J Method and apparatus for aiding severed nerves to join
US3797047A (en) * 1971-04-30 1974-03-19 Rhone Poulenc Sa Artificial tendon
US3833002A (en) * 1973-09-10 1974-09-03 J Palma Apparatus for aiding severed nerves to join
US3842441A (en) * 1972-10-12 1974-10-22 A Kaiser A temporary implant and method for tendon surgery
US3938528A (en) * 1973-05-11 1976-02-17 Investors In Ventures, Inc. Implanting and splicing articles and methods for living beings

Patent Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3463158A (en) * 1963-10-31 1969-08-26 American Cyanamid Co Polyglycolic acid prosthetic devices
US3577837A (en) * 1968-04-30 1971-05-11 Karl F Bader Jr Subdermal tendon implant
US3797047A (en) * 1971-04-30 1974-03-19 Rhone Poulenc Sa Artificial tendon
US3786817A (en) * 1972-06-01 1974-01-22 Palma J Method and apparatus for aiding severed nerves to join
US3842441A (en) * 1972-10-12 1974-10-22 A Kaiser A temporary implant and method for tendon surgery
US3938528A (en) * 1973-05-11 1976-02-17 Investors In Ventures, Inc. Implanting and splicing articles and methods for living beings
US3833002A (en) * 1973-09-10 1974-09-03 J Palma Apparatus for aiding severed nerves to join

Cited By (24)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0249346A2 (en) * 1986-05-15 1987-12-16 Jonathan Paul Beacon A prosthetic ligamentary device
EP0249346A3 (en) * 1986-05-15 1988-11-30 Jonathan Paul Beacon A prosthetic ligamentary device
US4795465A (en) * 1987-05-14 1989-01-03 Hood Laboratories Tracheobronchial stent
US4979956A (en) * 1987-10-30 1990-12-25 Pfizer Hospital Products Group, Inc. Device and method for tendon and ligament repair
US5061283A (en) * 1987-10-30 1991-10-29 Pfizer Hospital Products Group, Inc. Method for tendon and ligament repair
US6080192A (en) * 1994-12-02 2000-06-27 Omeros Medical Systems, Inc. Tendon and ligament repair system
US6106556A (en) * 1994-12-02 2000-08-22 Omeros Medical Systems, Inc. Tendon and ligament repair system
US5800544A (en) * 1994-12-02 1998-09-01 Omeros Medical Systems, Inc. Tendon and ligament repair system
US20020084078A1 (en) * 1999-02-26 2002-07-04 Shell Oil Co. Method of operating an apparatus for radially expanding a tubular member
US6740100B2 (en) 1999-12-23 2004-05-25 Omeros Corporation Tendon repair using adhesive
US20040215218A1 (en) * 1999-12-23 2004-10-28 Omeros Corporation Tendon repair using internal reinforcing member
US8006700B2 (en) 2000-02-07 2011-08-30 Demopulos Gregory A Soft tissue repair system
US20020169477A1 (en) * 2000-02-07 2002-11-14 Omeros Medical Systems, Inc. Soft tissue repair system
US20040010276A1 (en) * 2000-05-19 2004-01-15 Daniel Jacobs Multi-point tissue tension distribution device and method, a chin lift variation
US20050119694A1 (en) * 2000-05-19 2005-06-02 Jacobs Daniel I. Remotely anchored tissue fixation device and method
US7510566B2 (en) 2000-05-19 2009-03-31 Coapt Systems, Inc. Multi-point tissue tension distribution device and method, a chin lift variation
US20020022861A1 (en) * 2000-05-19 2002-02-21 Daniel Jacobs Multi-point tissue tension distribution device, a combined orbital rim repair and suspension variation, and a method of tissue approximation using the device
US20030142676A1 (en) * 2002-01-25 2003-07-31 Raymond Zeisz Method and apparauts for admission control in packet switch
US20050197699A1 (en) * 2004-02-10 2005-09-08 Jacobs Daniel I. Tissue repair apparatus and method
US20050209542A1 (en) * 2004-03-16 2005-09-22 Jacobs Daniel I Tissue approximation sling and method
WO2005104962A3 (en) * 2004-04-23 2007-11-08 Coapt Systems Inc Remotely anchored tissue fixation device and method
KR100885341B1 (en) * 2004-04-23 2009-02-26 코압트 시스템즈 인코포레이티드 Remotely anchored tissue fixation device and method
US20080021554A1 (en) * 2004-12-13 2008-01-24 Stone Kevin T Composite Collagen Material And Method Of Forming Same
US7998204B2 (en) * 2004-12-13 2011-08-16 Biomet Sports Medicine, Llc Composite collagen material and method of forming same

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Effective date: 19890226